Methadone and Depression

Do Methadone and depression go hand in hand? I've had a visit with a psychiatrist who insists that it's IMPOSSIBLE to have chronic pain for several years and not become clinically depressed aka needing depression medication. She says I will never have any success with pain management (right now I'm trying methadone) if I don't treat the depression at the same time. My strong feelings are that I don't want to be mixing two medications, at least not right now when I'm just beginning with the methadone, because I won't be able to tell what medication is doing what. I've had so many bad experiences with multiple side effects, that I just can't handle any more. The pain is enough to deal with right now. However, am I jeopardizing my chances of success with Methadone by not taking antidepressant meds? Anybody have success taking Methadone and an antidepressant i.e. not totally zombied out or nauseated?

Linda,
I kinda agree that if you live with pain daily that is a given that it will have a negative impact on our emotions.with that said i think most cp patients do battle with depression weather they realize it or not.

im not advocating using SSRI's but rather meds like the TCA Anti'Ds
i have read that ssris will not help cp patients on opiates but tca's like elavil will help w/depression and pain.
i never took methadone so i cant offer anything as far as that goes.
scott

What you expect? He is a psychiatrist, and they write drugs like that. Its good for their business. Go see a surgeon & I'll bet he'll offer to cut something too! TCAs help slightly with neuropathy pain, but very little else. TCAs, SSRIs, and SNRIs all have very nasty side effects, have the potential to sensitize you to depression, restructure your brain, and despite the drug industry commercials can rarely beat sugar pills in trials. My personal opinion is tell your psyche to get bent. Do as much as you can for you, do what you have to in your trial of methadone to see if it will work for you to relieve your pain, consider physical therapy (if you have something it could help) or what other modalities are available.

Of course you feel some loss and maybe occasional depression. I miss my old life, waking up and feeling decent every day, and quite frankly there are a lot of things I just can't do anymore. I have less money, less sex, less friends, and far far far less cool tech toys to play with every day. You accept it, adjust to it, and get on with it. But yeah, it will well up from time to time if you let your thinking get that way! If you can manage it, and I know its hard with pain -- exercise, do what you can. That does more to ward off depression than any pill they can give you.

Give your pain management trial a fair shot, and a lot of those blues may lift, if in fact you have any. Only you know how bad/good your psychological state is. I'm not a big believer in what they have to offer as far as drugs go, but I'm not biased without reasons to be biased. They are a profession with a dismal track record, very poor science, dismal human rights record, and millions of people harmed. Those types of medicines should be a last resort, never a first... You might do better working with someone whose first inclincation isn't drugs, maybe a psychologist or a plain ol' social worker. They tend to be solutions based and you can work on problems for more than 15 minutes without a 280 dollar fee - and they wont give you drugs which so impair your insight as to not be able to judge if something is helping or not.

I belive it is possible to have chronic pain and not depression. But it is hard and takes a very strong person. Even if you psych belives they go hand in hand, why MUST you have a drug to fught it? Whatever happened to talk and cognitive therapy? I have CP and depression and take both types of meds. But I have also had clinical depression for many years. I take methadone (20mg BID) and Cymablta (60mg once daily). I am not loopy, zombied, out of it, or nauseated. It is just a question of what helps you. If you feel you'd like to try something, you can always stop (titrate off) when you want to. The only thing that matters here is your good health.
Phosperos was right when he said this is what psychs do. They love to write scripts and give anti-depressants. They don't seem to know anything else.
Meds are an adjunct to therapy. Be it physical therapy for CP, cognitive therapy for depression, anxiety, etc... Do what YOU think is going to help yourself.

Hi Linda! wow you and I are in the same boat! I've fought off the anti d's for yrs and so many meds that made me worse off! Yes I am depressed, dah, 20 yrs of chronic pain and now total disability ( ddd, osteo, failed cervical fusion, lumbar discectomy, all joints arhtritic , several more discs bulging, to name a few issues, lol) I am back on the meth route too. I think if we could feel some pain relief the depression would lesson? Yep like the others can't do all the fun stuff anymore and jump out of bed ready to go. Yep, the dating is done and being alone stinks but kinda glad cause I don't have to burden anyone but my poor little dog. I am forgoing the anti d route and sticking to the culprit, pain. I want what ever senses are left in my body to be there!!!! My body may be a mess but my mind I plan on keeping, what little of it there is, lol